Commissioning Framework
In 2022/23, the NHSE Mental Health, Learning Disability and Autism Quality Transformation Team undertook an extensive engagement exercise. The aim was to gather views and expertise of individuals concerned with the commissioning, delivery and improvement of mental health inpatient services. In doing so, it identified key themes and priorities where intervention and support to improve quality was required.
The ask was a clear request for a shared understanding of ‘what good looks like’ for inpatient services and to support commissioners and providers to build on existing good practice to ensure every person admitted to an inpatient service experiences safe personalised, effective and compassionate care.
The 2023/24 NHS England priorities and operational planning guidance outlines the requirement for ICB’s to co-produce a strategic plan to localise and realign mental health inpatient services over a 3-year period as well as improving the experience and outcomes for those individuals who access inpatient care.
The West Yorkshire Mental Health, Learning Disability and Autism Collaborative brings together Bradford District Care NHS Foundation Trust; Leeds and York Partnership NHS Foundation Trust; South West Yorkshire Partnership NHS Foundation Trust; and Leeds Community Healthcare Trust. The collaborative works to ensure everyone in West Yorkshire receives the best care and support possible, working with other partners such as the voluntary community social enterprise sector, local councils, and other NHS and Independent sector organisations.
This document aims to support the data collection tools provided by the NHS NEYH Regional team, to outline the draft of West Yorkshire’s system priorities for inpatient quality. It does not detail all the ongoing priority and improvement plans available within each provider, some of which focus on recovery planning post the Covid-19 pandemic and include well known common challenges such as workforce gaps and high levels of demand.
Our approach to ensuring the commissioning framework remains dedicated to improving the quality of care in our inpatient services, is to highlight where there are shared commonalities in those improvement plans and understand where variance is unwarranted. The intention remains to work together as a system to develop strategies where we wish to ‘do the work once’ and where we can see greatest impact in pooling resources and sharing best practice.
The way we work
In order to help deliver our programme’s strategy, the four mental health/learning disability trusts in the partnership area have formed a Collaborative which is beginning to help drive forward the system changes that need to be made, remove barriers to integration and ultimately ensure that our resident population receive the best care and support that can be offered within finite resources.
This may mean that some providers will no longer provide specific services that they historically provided and that these will be commissioned once through a provider lead which will ensure that equity of access, service modernisation and integration happens across the West Yorkshire Health and Care Partnership. Through the Collaborative, providers will share and learn from their experiences, including what has not gone well, offer peer support and challenge. Boundaries between services, organisations and across the provider/commissioner landscape will begin to blur focusing on becoming “one workforce” with a collective ambition. Where local place based governance arrangements are emerging that move beyond the historic transactional commissioner/provider arrangement we will share learning and potential benefits/challenges across the ICS partnership.
Mental health care is often disconnected from the wider health and care system, and as a result, people do not always receive coordinated support for their physical health, mental health and wider social needs. The programme will strive to correct this and assure that, in partnership with our 6 places and within the workstreams. Standardising practice can aid with this integration; for example by working to common policies and procedures and having the same anticipated outcomes. We must also ensure that the learning and innovation in each of our 6 places, who have their own local ambition to create prevention-focused integrated services, is shared across the system and identify where it makes sense to either:
- Collaborate to ensure we reduce variation
- Utilise and develop professional and clinical leadership to help drive transformation and its adoption
- Standardise an approach where there is evidence base that it works well and where it supports a better interface with a region wide service eg police, ambulance
- Commission once to standardise the offer, integrates better, and reduces duplication
- Integrate services, including an “one workforce” ambition,to build resilience and reduce “hand offs”
- Reconfigure services to ensure viability and drive up quality of provision
- Integrate with other programmes of work to ensure physical/mental health integration
- Invest time in consideration about the way in which we work and our culture of collaboration
- Bring commissioning and provider functions closer together to transform services (initially using commissioner lead and provider lead models but developing and blurring boundaries between the functions in the future).